HPV-related diseases in male patients: an underestimated conundrum

Abstract

Purpose Human papillomavirus (HPV) infection is the most common sexually transmitted disease, in males and females worldwide. While the role of HPV in female diseases is well known and largely studied, males have negligibly been included in these programs, also because the proportion of women suffering and dying from HPV-related diseases is much larger than men. The aim of this review is to focus on HPV-related diseases in male patients. Methods We performed a literature analysis on the electronic database PubMed. We considered randomized trials, observational and retrospective studies, original articles having as topic the relationship between HPV male infection and the following items: oral, anal penile cancers, warts, condylomas, male infertility, altered sperm parameters, anti-sperm antibodies (ASA). We also included experimental in vitro studies focused on the effects of HPV infection on oocyte fertilization, blastocyst development, and trophoblastic cell invasiveness. In addition, studies describing the adjuvant administration of the HPV vaccination as a possible strategy to promote HPV clearance from semen in infected males were included. Results Regarding head and neck HPV-related diseases, the most important non-neoplastic disease is recurrent respiratory papillomatosis (RRP). Regarding neoplastic diseases, the proportion of head and neck cancers attributable to HPV has increased dramatically worldwide. In addition, nowadays, it is thought that half of head and neck squamous cell carcinomas (HNSCCs) cases in the United States are caused by infection with high-risk HPV. HPV is noteworthy in andrological practice too. It was described as having a high HPV prevalence, ranging between 50 and 70%, in male penile shaft, glans penis/coronal sulcus, semen as well as in scrotal, perianal, and anal regions. Moreover, in male patients, HPV infection has been associated, among other diseases, with penile cancers. HPV semen infection has been reported in about 10% in men from the general population and about 16% in men with unexplained infertility, although these data seem widely underestimated according to clinical experience. In particular, HPV semen infection seems to be most related to asthenozoospermia and to anti-sperm antibodies (ASAs). Conclusions HPV infection represents a health problem with a detrimental social and public impact. Despite this evidence, little has been done to date to widely promote vaccination among young males.

Human Papillomavirus and Male Infertility: What Do We Know?

“…A few years later, Foresta et al [29] reported a strong correlation between asthenozoospermia, ASAs, and HPV sperm infection, regardless of the genotype, and further described in a subsequent study by Garolla et al [67]. Indeed, in several men with idiopathic asthenozoospermia, the presence of HPV DNA in semen appears to be the only risk factor detectable [29] (Table 1).…”

HPV status and immunohistochemical analysis of p16, p53 and PD‑L1 expression as prognostic biomarkers in patients with squamous cell anal cancer receiving definitive radiotherapy/chemoradiotherapy

“…In addition, there is a concerning lack of awareness among adolescents, including medical students, regarding HPV and its vaccines. Greater efforts, potentially including mandatory measures, are required to increase awareness, particularly among males and young people ( 57 ). Accordingly, a risk-adaptive approach is necessary for patients with anal SCC.…”

Molecular detection of transcriptionally active ovine papillomaviruses in commercial equine semen

“…Although a possible correlation between HPV sperm infection, asthenozoospermia, and male fertility has been suggested ( 29 ), it is believed that HPV negatively affects the fertility of both males and females ( 30 ). Therefore, HPV infection of semen may be responsible for the reduction in natural and assisted pregnancy rates and a risk factor for pregnancy interruption ( 31 ). The exact mechanism by which sperm infection impairs fertility requires further investigation ( 22 , 30 ), considering that the transcriptional activity of HPV has never been detected in human semen ( 32 ).…”